"Boss, anesthesia is a big problem," Su Yun said. "The extracorporeal circulation group can only find Lao He to do it first. We can't take up so long for a group of people."

"Well, thank you for your hard work, Lao He will watch back and forth. If there is any problem between ecmo and external circulation, Lao He will watch it." Zheng Ren knew what Su Yun meant.

"Yes, because Old He can't watch it, do you want to call Da Chu and Xiao Chu?" Su Yun asked.

"Is it convenient to go home?"

"If you say you can, I will ask again, otherwise Big Chu and Xiao Chu will come. If you say you can't, that's how embarrassing."

"Come on, I'll tell Director Xu. After all, it's time to do about one week of surgical training, so it's hard to find others in the anesthesia department to accompany you all the time." Zheng Ren nodded and finalized the matter.

Lin Yuan and Gu Xiaoran are ready to go. As long as anyone who has been working in clinical practice for a period of time knows, this operation will inevitably go down in history.

Autologous stem cell cloning and 3D printing of lung transplantation will inevitably write a brilliant stroke in the history of medicine, and may turn into an invisible big hand into a page of modern medical history.

Waiting for Yiren and Lao He to go to the community hospital to prepare for surgical training.

The last time I had such an exaggerated preoperative training was the same as the one I had a heart conjoined infant separation surgery in the Women and Children’s Hospital.

Overall, the difficulty is smaller than the separation of the heart, but Zheng Ren is still ready to do his best without leaving any effort.

He even gathered the entire medical team again without hesitation.

Seeing Su Yun bringing Gu Xiaoran, Lin Yuan moved the 3D-printed simulator to the operating table in the classroom to prepare preoperatively. Zheng Ren took the opportunity to come to the system space and clicked to buy the surgical training time.

As the system operating room rose from the ground, Zheng Ren silently prayed in his heart, and then got in.

Fortunately, as I imagined, the 3D printed cloned lung tissue is placed in the operating room and there is no need to spend a lot of money to buy at the system mall.

Zheng Ren expressed his satisfaction with this.

The operation started with anesthesia. Zheng Ren did not throw this part to Lao He. After all, the 3D printing simulator and real person have essential differences.

Zheng Ren began to try anesthesia and went to ecmo.

First, the mask was given to the experimental question and absorbed pure oxygen, with a volume fraction of 100%, and the electrocardiogram and blood oxygen saturation were monitored. Then, Zheng Ren performed a right radial artery puncture and catheter to monitor invasive blood pressure and performed blood gas analysis.

Imidazole 1-2 mg and etomidate 0.2-o were used for induction of anesthesia.

4 mg/kg.Supfentanil 0.2～o.

4mg/kg and atracuronium cisphenylsulfonic acid 0.15～o.

3 mg/kg.

After entering the muscle relaxation state, tracheal intubation begins and connects a ventilator to assist in breathing.

Maintaining anesthesia, intravenous infusion of propofol was performed at 0.03 to 0.05 nag·kg.1·min, vecuronium bromide 1 to 2ug/kg/·min. Indirect intravenous injection of fentanyl was maintained.

Zheng Ren observed the status of the experimental subject for a period of time and conducted blood and gas analysis intermittently.

The blood gas value is not stable because the ventilation methods are all controlled by pressure, so Zheng Ren adjusts ventilation parameters based on the blood gas analysis indicators and vital signs, and decides to perform manual ventilation when necessary.

After anesthesia induction, the right femoral artery was intubated with a 15-17 fr catheter, and the femoral artery was intubated to the level of the common iliac artery; the femoral vein was intubated to the level of the inferior vena cava. The entire heparin-coated membrane of the lungs and pipes, thermostats, centrifugal pump head and oxygenator were selected. The catheter was placed in person and then the flow began.

The maximum flow rate of ecmo is usually determined by the cannula. Each cannula has its own special flow-pressure curve. The larger the cannula, the higher the flow rate. For example, the arterial cannula of No. 17 can only reach a flow rate of 4 to 5 l per minute, while the cannula of No. 21 can achieve a flow rate of 6 l per minute without causing additional pressure to the tube wall.

Considering Xiao Shitou's age factor, Zheng Ren tried many times and finally chose the most suitable model of intubation.

The initial flow rate is 50% of the interrupted cardiac output, and the flow rate is maintained above 30% during the transfer period. During the operation, the speed and flow rate are adjusted according to oxygenation and cardiac function.

Zheng Ren did not buy an assistant to help him with the surgery, but this time he just explored his experience. Although there was a lot of time left in the remaining surgical training, Zheng Ren was not ready to "waste".

During this operation, Zheng Ren did not think that the 3D-printed cloned lung tissue could be perfectly competent. If there was an abnormal situation, he would take Su Yun away, and then "hide the truth" and replace the 3D-printed lung tissue brought by Su Yun's familiar laboratory with the lung tissue.

This is very risky, but Zheng Ren has made the worst preparations for the success of the operation.

The lung tissue that can be used for transplantation can only be redeemed with hundreds of thousands of experience values, which is more expensive than what was used in the system space before.

Come on a little bit, I hope the lung tissue provided by Su Yun can be more reliable.

When the operation started, Zheng Ren discovered an abnormality.

Before the ecmo flow dropped, he observed the phenomenon of "pipe tremor".

This is because when the blood vessel content is at a low level, the negative pressure in the ecmo line causes the venous cannula to impact the venous wall.

Continuous tremor may cause ecmo alarms or "sucking the wall to decrease the flow". Zheng Ren lowered the ecmo flow and found that the tremor amplitude could be quickly alleviated; then he used the method of slowly increasing the ecmo flow while expanding the capacity and slowly increasing the ecmo flow.

Normally, pipeline tremor is not rare in the use of ecmo. I think Lao He has encountered it many times. However, Zheng Ren was very careful to solve the situation of pipeline tremor little by little. He can clearly understand how to expand capacity and how much dosage to avoid pipeline tremor.

Just one detail, 30 hours of surgical training time wasted.

The surgery is getting bigger and bigger, and the surgical training time is also consumed. Fortunately, there are 3D printing simulators for training, otherwise, if you buy assistants in the system operating room, you will probably not be able to train a few times after a series.

However, what made Zheng Ren more pleased was that the 3D printed cloned lung tissue brought by Su Yun was quite good. After completing the operation, the system actually gave 88% of the operation completion.

This degree of completion is relatively low in the surgery performed by Zheng Ren, but what Zheng Ren has proved is that there is no essential difference between 3D printing tissue and tissue purchased in the system space.

As long as it's okay, Zheng Ren doesn't want to become a living person and develops lung tissues and organs.

A laryngoscopy and a blade are all trivial matters, so you can explain them casually. Even if Su Yun or others have doubts, they will think that Zheng Ren is obsessive-compulsive disorder, but it is just a coincidence.

But a lung emerges...

Is it a reselling human organs? If that is the case, as long as people are noticed, the consequences will be unimaginable.

Cloning the lungs should work, which is the best news Zheng Ren has obtained.
Chapter completed!